Capillary blood glucose monitoring (Formulary)

TAM (Treatments and Medicines) NHS Highland
NHS Highland

The different meters on the market all require different testing strips/devices. Stocking many types of meter is potentially wasteful and can be confusing for patients and health-care professionals. The guidance given below is intended to help match glucose meters to individual requirements bearing in mind that many of the type 2 diabetes population do not require a multi-function meter, therefore it is suggested that the following meters listed below be used in NHS Highland.

 All meters are subject to inaccuracies arising from:

  • Poor technique: lack of hand washing can lead to contaminated samples giving an inaccurate result. Wash hands with soap and water before taking a sample. Using just hand sanitiser may alter the blood glucose result.
  • Insufficient blood on the test strip: all of the advised meters use a capillary fill system so the strip ‘sucks up’ the blood rather than it being applied to the top of the strip. If the blood is incorrectly applied the meter will not work.
  • Temperature: meters and strips are designed to be most accurate at room temperature. If the meter is too cold it may not function.
  • Humidity will also affect test strips. They should be stored in the container with the top closed and used within manufacturers’ recommended time after opening.
  • Disposal of blood glucose meters Spirit Healthcare are able to collect old blood glucose meters (both their own meters and other companies' meters).  They recycle the meters and ensure none go to landfill.  The email address to contact is: cs@spirit-healthcare.co.uk
Avoid comparing results from different meters as different meters will provide varying readings leading to confusion.

For information on which patients should monitor their glucose and how often, see: Diagnostic and monitoring devices for diabetes

ADULTS WITH TYPE 2 DIABETES

Therapy notes

Formulation and dosage details

Formulation:

Accu-Chek Instant
Best for a basic economical blood glucose meter. 

  • Can also be linked to MySugr app to support review of blood glucose levels remotely by healthcare professionals. 
  • Colour grading on meter to support patient knowledge of target range of glucose levels.

Dosage:

  • Accu-Chek Instant glucose strips
  • Fast-Clix lancets
    Enclosed in drum to minimise sharps injury. No need for separate sharps container.

Formulation and dosage details

Formulation:

Accu-Chek Mobile
Best for adults who find test strips inconvenient.

  • Can also be linked to MySugr app to support review of blood glucose levels remotely by healthcare professionals 

Dosage:

  • Roche Accu-Chek Mobile test cassette 
    Glucose strips enclosed with the meter to aid disposal.
  • Fast-Clix lancets
    Enclosed in drum to minimise sharps injury. No need for separate sharps container.

Formulation and dosage details

Formulation:

AgaMatrix Wave Sense Jazz
Great meter for majority of testing patients.

  • Easy to use and teach for those who require simple testing.
  • Pre-set with date and time, ready to use straight from the box.
  • Can connect to software to support remote management.
  • Online video tutorials and language guides to support remote training.

Dosage:

  • AgaMatrix Wave Sense Jazz strips
  • AgaMatrix lancets
    Finest available lancet. Re-cappable to minimise sharps injuries

Formulation and dosage details

Formulation:

AgaMatrix WaveSense Jazz Wireless
Great meter for smartphone users.

  • Small and discreet Bluetooth meter that links with the intuitive AgaMatrix Diabetes Manager app, which provides colour coded feedback to aid patient interpretation of results and support remote management.
  • Easy to use and teach, with online video tutorials and language guides to support remote training.

Dosage:

  • AgaMatrix Wave Sense Jazz strips
  • AgaMatrix lancets
    Finest available lancet. Re-cappable to minimise sharps injuries

Formulation and dosage details

Formulation:

GlucoRx Nexus 
For existing users of these meters.

  • Family of meters including Nexus Voice talking meter (for visually-impaired)
  • A useful alternative to Accu-Chek instant for patients with dexterity issues.

Dosage:

  • GlucoRx Nexus strips
  • GlucoRx lancets

ADULTS WITH TYPE 1 DIABETES

Therapy notes

Formulation and dosage details

Formulation:

CareSens Dual Meter
For adults with type 1 diabetes who test both blood glucose and ketones

Dosage:

  • CareSens PRO strips
  • KetoSens strips
  • CareSens lancets

Formulation and dosage details

Formulation:

Accu-Chek Guide Link meter
For adults who use a Medtronic 780G insulin pump

Dosage:

  • AccuChek Guide strips
  • FastClix lancets
    Enclosed in drum to minimise sharps injury. No need for separate sharps container.

Formulation and dosage details

Formulation:

Ypsomed
For adults using an Ypsomed insulin pump

Dosage:

No specific meter linked to pump

Formulation and dosage details

Formulation:

Medtrum
For adults using a Medtrum insulin pump

Dosage:

No specific meter linked to pump

Formulation and dosage details

Formulation:

Contour Next Link USB meter  
For existing patients only who use a Medtronic 640G insulin pump. Not for new patients.

Dosage:

  • Contour Next strips
  • Contour lancets

Formulation and dosage details

Formulation:

Omnipod handset
For existing patients only who are using an Omnipod insulin pump and handset. Not for new patients.

Dosage:

  • FreeStyle Lite strips
  • Freestyle lancets

Formulation and dosage details

Formulation:

Adults with type 1 diabetes who use carb advisor: 
There is no longer a specific device for those 'carb counting'. Consideration can be given to mobile apps eg. My Sugr app and MyLife app

Formulation and dosage details

Formulation:

FreeStyle Libre 2: Flash glucose monitoring system (Restricted: Specialist recommendation only)
For eligible patients based on clinical need and criteria

Note - when a new ‘reader’ is ordered an envelope will be sent to return the old reader/meter to Abbot for recycling.  For further information see website.

Dosage:

  • FreeStyle Libre 2 sensors
    One month supply: 2 sensor kits

Formulation and dosage details

Formulation:

FreeStyle Libre 2 plus: Flash glucose monitoring system (Restricted: Specialist recommendation only)
For eligible patients based on clinical need and criteria

Note - when a new ‘reader’ is ordered an envelope will be sent to return the old reader/meter to Abbot for recycling.  For further information see website.

Dosage:

  • FreeStyle Libre 2 sensors
    One month supply: 2 sensor kits

Formulation and dosage details

Formulation:

FreeStyle Libre 3: Flash glucose monitoring system (Restricted: Specialist recommendation only)
For eligible patients based on clinical need and criteria

Note - when a new ‘reader’ is ordered an envelope will be sent to return the old reader/meter to Abbot for recycling.  For further information see website.

Formulation and dosage details

Formulation:

Dexcom ONE: Continuous glucose monitoring (CGM) system (Restricted: Specialist recommendation only)
For eligible patients based on clinical need and criteria

Dosage:

  • Dexcom One sensors and Dexcom One transmitter
    For 12 weeks supply: 1 transmitter and 3 x 3 sensor kits

GESTATIONAL DIABETES WHO NEED TO BLOOD GLUCOSE TEST

Therapy notes

Formulation and dosage details

Formulation:

Accu-chek instant
For pregnant women who need to blood glucose test

  • Accu-Chek platform allows health professionals to review readings remotely.
  • Can also be linked to MySugr app to support review of blood glucose levels remotely by healthcare professionals. 
  • Colour grading on meter to support patient knowledge of target range of glucose levels.

Dosage:

  • Accu-Chek Instant glucose strips
  • FastClix lancets
    Enclosed in drum to minimise sharps injury. No need for separate sharps container.

Formulation and dosage details

Formulation:

AgaMatrix Wave Sense Jazz
Alternative if Accu-Chek instant is not available

Dosage:

  • AgaMatrix Wave Sense Jazz strips
  • AgaMatrix lancets

CHILDREN WITH DIABETES

Therapy notes

Formulation and dosage details

Formulation:

Accu-Chek Instant meter
For children as advised by the Paediatric Diabetes Team

Dosage:

  • Accu-Chek Instant glucose strips
  • FastClix lancets

Formulation and dosage details

Formulation:

Accu-Chek Guide Link meter
For children who use a Medtronic 780G insulin pump 

Dosage:

  • Accu-Chek Guide glucose strips
  • FastClix lancets

Formulation and dosage details

Formulation:

Contour Next USB Link meter
For children who use a Medtronic 690G insulin pump

Dosage:

  • Contour Next strips
  • FastClix lancets

Formulation and dosage details

Formulation:

CareSens Dual meter 
For ketone testing in children

  • Not for use in neonates

Dosage:

  • KetoSens strips
  • FastClix lancets

Formulation and dosage details

Formulation:

Insulin pump
For paediatric patient enquiries, please contact the Paediatric Diabetes Team directly. Tel: 01463 701321 or email: nhshighland.childdiabetes@nhs.scot 

Formulation and dosage details

Formulation:

Glucose interstitial fluid detection sensor (Freestyle Libre / Dexcom)

GP's will be notified by letter by the Paediatric Diabetes Team if a specific patient has met all the requirements for these to be safely prescribed. Please contact the Paediatric Diabetes Specialist Nurses

Tel: 01463 701321 or email: nhshighland.childdiabetes@nhs.scot for any enquiries.

HOSPITAL IN-PATIENT DIABETES MONITORING DEVICES

Therapy notes

Formulation and dosage details

Formulation:

FreeStyle Precision Pro meter

  • Blood glucose monitoring: all hospital locations
  • Blood ketone monitoring: specialist areas only.

Dosage:

  • FreeStyle Precision Pro glucose strips
  • FreeStyle Precision Pro ketone strips
    Only as directed by Biochemistry
  • Vitrex sterile safety lancets

Editorial Information

Last reviewed: 23/04/2024

Next review date: 27/06/2024

Author(s): Endocrinology.

Version: 2

Approved By: Awaiting approval by the TAMSG of the ADTC

Document Id: F384